ID 110386
Title Transcription
イ ショクドウ ギャクリュウショウ ニ タイスル フククウキョウカ Nissen フンモン ケイセイジュツ ニオケル ショクドウ チョクセツ コテイ ノ ジュウヨウセイ ニ カンスル ケントウ
Title Alternative
A study on the importance of the direct suture between the esophagus and diaphragmatic crus in laparoscopic Nissen fundoplication for gastro-esophageal reflux disease
Author
Mori, Hiroki Department of Pediatric and Pediatric Endoscopic Surgery, the University of Tokushima Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Ishibashi, Hiroki Department of Pediatric and Pediatric Endoscopic Surgery, the University of Tokushima Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Yada, Keigo Department of Pediatric and Pediatric Endoscopic Surgery, the University of Tokushima KAKEN Search Researchers
Shimada, Mitsuo Department of Digestive and Transplantation Surgery, the University of Tokushima Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
gastro-esophageal reflux disease(GERD)
laparoscopic Nissen fundoplication
recurrence
esophagus direct suture
neurologically impaired(NI)children
Content Type
Journal Article
Description
【Background】 For the neurologically impaired(NI)patients with gastro-esophageal reflux disease(GERD) who underwent laparoscopic Nissen fundoplication, the direct suture between the esophagus and diaphragmatic crus(esophagus direct suture)was changed from one to three stiches in order to prevent the postoperative recurrence due to wrap herniation. Therefore, the postoperative outcome was evaluated before and after this change retrospectively.
【Methods】 Seventy-two NI patients( 53 boys and 19 girls, mean age91. years old)with GERD performed laparoscopic Nissen fundoplication from 2005 to 2012 were enrolled in this study. Surgical procedure was laparoscopic Nissen fundoplication for all patients and additional gastrostomy at the same time for68cases(94%). Patients were divided into the following two groups : early period group(n=27)and late period group(n=45). The early period group included the number of esophagus direct suture was one stitch from2005to2007and the late period group included the number of esophagus direct suture was three stitches from2008to2012.
【Results】 There was no intraoperative complication in both two groups. In postoperative complication rate, there was no significant difference between the two groups though one case(2.2%)showed a gastric perforation in the late period group. Postoperative recurrence was found 9 cases (12.5%)due to wrap herniation. In postoperative recurrence rate, the early period group was 22.2%(n=6)and the late period group was 6.7%(n=3). The modified esophagus direct suture by from one stitch to three stitches had a tendency to decrease the postoperative recurrence rate(p=0.05). For nine recurrent cases, re‐operation was performed in two patients, esophagogastric dissociation in one patients and observation in six patients.
【Conclusions】 Devising the esophagus direct suture in the laparoscopic Nissen fundoplication for NI patients might have the possibility to prevent the recurrence due to wrap herniation.
Journal Title
四国医学雑誌
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
72
Issue
3-4
Start Page
101
End Page
106
Sort Key
101
Published Date
2016-08-25
EDB ID
FullText File
language
jpn
TextVersion
Publisher
departments
University Hospital
Medical Sciences